{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:53:55Z","timestamp":1786978435297,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To determine outcomes of children with rhabdomyosarcoma (RMS) with isolated lung metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were analyzed for 428 patients with metastatic RMS treated on COG protocols. Categorical variables were compared using Chi\u2010square or Fisher's exact tests. Event\u2010free survival (EFS) and overall survival (OS) were estimated using Kaplan\u2013Meier method and compared using the log\u2010rank test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with patients with other metastatic sites (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0373), patients with lung\u2010only metastases (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a055) were more likely to be &lt;10 years of age, have embryonal histology (embryonal rhabdomyosarcoma), have N0 disease, and less likely to have primary extremity tumors. Lung\u2010only patients had significantly better survival outcomes than patients with all other sites of metastatic disease (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001) with 5\u2010year EFS of 48.1 versus 18.8% and 5\u2010year OS of 64.1 versus 26.9%. Patients with lung\u2010only metastases, and those with a single extrapulmonary site of metastasis, had better survival compared with patients with two or more sites of metastatic disease (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001). In patients with ERMS and lung\u2010only metastases, there was no significant difference in survival between patients \u226510 years and 1\u20139 years (5\u2010year EFS: 58.3 vs. 68.2%, 5\u2010year OS: 66.7 vs. 67.7%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>With aggressive treatment, patients with ERMS and lung\u2010only metastatic disease have superior EFS and OS compared with patients with other sites of metastatic disease, even when older than 10 years of age. Consideration should be given to including patients \u226510 years with ERMS and lung\u2010only metastases in the same group as those &lt;10 years in future risk stratification algorithms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.30293","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T08:39:51Z","timestamp":1678783191000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Rhabdomyosarcoma with isolated lung metastases: A report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-7639","authenticated-orcid":false,"given":"Juan C.","family":"Vasquez","sequence":"first","affiliation":[{"name":"Department of Pediatrics Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo Y.","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt\u2010Ingram Cancer Center Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4723-2151","authenticated-orcid":false,"given":"Susan M.","family":"Hiniker","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1895-6679","authenticated-orcid":false,"given":"Daniel S.","family":"Rhee","sequence":"additional","affiliation":[{"name":"Department of Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshni","family":"Dasgupta","sequence":"additional","affiliation":[{"name":"Division of Pediatric General and Thoracic Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda J.","family":"Weigel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\/Oncology University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Biostatistics College of Public Health and Health Professions and College of Medicine University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajkumar","family":"Venkatramani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Baylor College of Medicine Texas Children's Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carola A.","family":"Arndt","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine Mayo Clinic and Foundation  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"SEER Cancer Statistics Review, 1975\u20132018","author":"Howlader N 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